Preterm birth, birth weight, infant weight gain and their associations with childhood asthma and spirometry: a cross-sectional observational study in Nairobi, Kenya

Meme, Hellen, Amukoye, Evans, Bowyer, Cressida, Chakaya, Jeremiah, Dobson, Ruaraidh, Fuld, Jonathan, Gray, Cindy M, Kiplimo, Richard, Lesosky, Maia ORCID: https://orcid.org/0000-0002-2026-958X, Mortimer, Kevin ORCID: https://orcid.org/0000-0002-8118-8871, Ndombi, Amos, Obasi, Angela ORCID: https://orcid.org/0000-0001-6801-8889, Orina, Fred, Quint, Jennifer, Semple, Sean, West, Sarah E, Zurba, Lindsay and Devereux, Graham ORCID: https://orcid.org/0000-0002-0024-4887 (2023) 'Preterm birth, birth weight, infant weight gain and their associations with childhood asthma and spirometry: a cross-sectional observational study in Nairobi, Kenya'. BMJ Open Respiratory Research, Vol 10, e001895.

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Abstract

Background
In sub-Saharan Africa, the origins of asthma and high prevalence of abnormal lung function remain unclear. In high-income countries (HICs), associations between birth measurements and childhood asthma and lung function highlight the importance of antenatal and early life factors in the aetiology of asthma and abnormal lung function in children. We present here the first study in sub-Saharan Africa to relate birth characteristics to both childhood respiratory symptoms and lung function.

Methods
Children attending schools in two socioeconomically contrasting but geographically close areas of Nairobi, Kenya, were recruited to a cross-sectional study of childhood asthma and lung function. Questionnaires quantified respiratory symptoms and preterm birth; lung function was measured by spirometry; and parents were invited to bring the child’s immunisation booklet containing records of birth weight and serial weights in the first year.

Results
2373 children participated, 52% girls, median age (IQR), 10 years (8–13). Spirometry data were available for 1622. Child immunisation booklets were available for 500 and birth weight and infant weight gain data were available for 323 and 494 children, respectively. In multivariable analyses, preterm birth was associated with the childhood symptoms ‘wheeze in the last 12 months’; OR 1.64, (95% CI 1.03 to 2.62), p=0.038; and ‘trouble breathing’ 3.18 (95% CI 2.27 to 4.45), p<0.001. Birth weight (kg) was associated with forced expiratory volume in 1 s z-score, regression coefficient (β) 0.30 (0.08, 0.52), p=0.008, FVC z-score 0.29 (95% CI 0.08 to 0.51); p=0.008 and restricted spirometry, OR 0.11 (95% CI 0.02 to 0.78), p=0.027.

Conclusion
These associations are in keeping with those in HICs and highlight antenatal factors in the aetiology of asthma and lung function abnormalities in sub-Saharan Africa.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WF Respiratory System > WF 140 Diseases of the respiratory system (General) WF Respiratory System > Lungs > WF 600 Lungs WS Pediatrics > WS 100 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjresp-2023-001895
Depositing User:	Christy Littlejohn
Date Deposited:	29 Sep 2023 10:22
Last Modified:	29 Sep 2023 10:22
URI:	https://archive.lstmed.ac.uk/id/eprint/23121

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